Exploring DBT

Hello Reader,

I hope you are doing well today!

“I am a bit better after practicing CBT and recognizing how my thoughts influence my actions and emotions, but I am still having some issues.” – Reader.

Is that so, Reader. What is happening?

“I keep having some strong emotions and acting in unhealthy ways! I don’t know what to do and it is very frustrating!” – Reader.

I’m so sorry to hear that. Let’s talk about DBT for a bit and see if that would work better for you.

DBT, or Dialectical Behavioral Therapy is growing on the ideas of CBT. It is very useful for those who are experiencing heavy and intense emotions.

Starting off, safety is key. This is where a therapist will work with you to limit behaviors. Afterward safety is established, DBT is very much a skill-based form of therapy. Mindfulness, distress tolerance, interpersonal advocacy, and emotional regulation are all skills that will be practiced in DBT. The DBT framework is below.

To get an idea of one of the skills within DBT, let’s look at the acronym, STOP. (Yes, I don’t know why us therapists love using acronyms, but we do!)

"S" is for you to practice stopping whatever you are doing. Walking in circles, stop. Reaching for objects, stop. "T" is to take a step back. Take two or three slow, deep breaths. You might even need to walk to a different room and changing your environment during this part. "O" stands for observe. Observe what you are experiencing. What are you tempted to do? What feelings and emotions are you experiencing? What are healthy and unhealthy choices to make in this moment? "P" stands for proceeding with caution. Proceed to act on what is healthy and safe for you.

Our emotions only tell us part of the story. They influence us to act on only that part of the story. It is our responsibility to be curious, explore, and figure out what are they not telling us. STOP can be a wonderful way to do this. We’ll explore this concept in a different blog.

Keep in mind that DBT is practicing behavioral change so you might not get in depth of where the issues are emerging from. It is in general saying, yes, this experience is happening to you, let’s recognize it and choose to do something healthy.

“This sounds like a lot of work, Jon” – Reader.

It can be but learning healthy skills is very important and if you were not taught how to manage strong emotions, now is a great time to learn!

We all can benefit from some part of DBT. What about you? What would benefit you? Being more mindful and aware of what you are experiencing so you can respond instead of react? Would practicing emotional regulation skills help so you can understand and manage the strong feelings and emotions that might emerge? Would distress tolerance skills and learning how to not make things worse in the moment help you? Or maybe practicing the skill of interpersonal effectiveness help where you can practice maintaining healthy relationships and express your needs in healthy ways?

The downside of DBT is that it can feel invalidating at times. It is a skills-based therapy. Frustration is common during DBT work because, well, it is new skills. It is important to talk with your therapist about any frustrations so you can understand the reason behind any frustrations. Be kind to yourself learning new skills and celebrate the small wins as you practice DBT.

Key takeaways:

1)      DBT is often used when experiencing strong feelings and emotions.

2)      DBT is skills based so it is important for you to PRACTICE not just in session but on your own.

3)      There are four parts to DBT, Mindfulness, Emotional Regulation, Distress Tolerance, and Interpersonal Effectiveness.

4)      DBT can be frustrating and dismissing at times so be kind to yourself and the process of learning new skills.